title: Osteoprotegerin is an independent predictor of vascular events in Finnish adults with type 1 diabetes.
abstract: OBJECTIVE
  Osteoprotegerin (OPG) is involved in the process of vascular calcification. We investigated whether OPG is associated with the development and progression of diabetes complications in adults with type 1 diabetes (T1D).
  
  
  METHODS
  Serum OPG was measured in 1,939 adults with T1D participating in the Finnish Diabetic Nephropathy (FinnDiane) Study. Patients with end-stage renal disease (dialysis or transplantation) at baseline were excluded from analysis. Data on cardiovascular (CV) events and mortality during follow-up were verified from hospital discharge registries (ICD codes) and the Finnish National Death Registry, respectively. The follow-up time was 10.4 ± 2.0 (mean ± SD) years.
  
  
  RESULTS
  Only patients with macroalbuminuria and/or renal impairment had elevated OPG concentrations, when compared with participants without overt kidney disease. Patients with retinopathy or CV disease also had higher OPG concentrations, but this was attributable to their higher frequency of chronic kidney disease. OPG predicted an incident CV event (hazard ratio 1.21 [95% CI 1.01-1.45]; P = 0.035) and peripheral vascular disease/amputation events (1.46 [1.13-1.88]; P = 0.004) during follow-up.
  
  
  CONCLUSIONS
  We showed that serum OPG is an independent predictor of CV complications. OPG may be directly involved in extraosseous calcification, resulting in stiffening of the arteries and subsequent vascular insufficiency in patients with T1D.
authors.affiliation: Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gordin
authors.forename: Aino
authors.initials: A
authors.lastname: Soro-Paavonen
authors.forename: Merlin C
authors.initials: MC
authors.lastname: Thomas
authors.forename: Valma
authors.initials: V
authors.lastname: Harjutsalo
authors.forename: Markku
authors.initials: M
authors.lastname: Saraheimo
authors.forename: Mette
authors.initials: M
authors.lastname: Bjerre
authors.forename: Carol
authors.initials: C
authors.lastname: Forsblom
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D053244:Osteoprotegerin / Q000097:blood*
chemical_list: D053244:Osteoprotegerin